Expanding Arthritis Therapies Top Agenda at EULAR

Maureen Salamon

June 03, 2019

MADRID — Much-needed options for the treatment of osteoarthritis will be in the spotlight at the upcoming European League Against Rheumatism (EULAR) Congress 2019.

John Isaacs

An aging world population highlights the lack of effective osteoarthritis treatments, said John Isaacs, MBBS, PhD, from Newcastle University in Newcastle Upon Tyne, United Kingdom, who is chair of the EULAR abstract selection committee.

"Given that osteoarthritis affects almost half of us, there is a significant need to try to avoid joint replacements," Isaacs told Medscape Medical News. "It's kind of where we were with rheumatoid arthritis 15 years ago, and now we have loads of treatments for that."

Phase 3 results from a study of subcutaneous tanezumab — a monoclonal antibody that selectively targets and inhibits nerve growth factor — for osteoarthritis pain with a 24-week follow-up will be presented during a late-breaking clinical trials session.

Previous research on tanezumab has produced conflicting results, with some osteoarthritis patients experiencing faster joint destruction despite reduced pain, Isaacs reported.

"It relieved pain, so patients were able to do things they otherwise couldn't do," he said. "We may just need to be careful with how we use it, but the fact that this is a phase 3 study is important."

Thomas Dörner

"We're still not where we want to be, but there may be new options to improve osteoarthritis and delay aging of the chondrocytes of the bones," added Thomas Dörner, MD, from Charité Universitätsmedizin Berlin, who is chair of the EULAR scientific program committee.

Other forms of arthritis will also be discussed. Results from an innovative study of an implantable vagus nerve stimulator, designed to gauge whether the device improves symptoms in rheumatoid arthritis, will be presented.

"This would be a very novel approach if it works," Isaacs said, explaining that stimulating the vagus nerve might also stimulate the spleen, which is highly involved in immune system function.

"I think there are a lot of connections between the immune and nervous systems that we're only just starting to appreciate," he added. "There have been hints over the years that there are differences in autonomic function in rheumatoid arthritis, so trials like this are starting to test this."

And psoriatic arthritis is the focus of an interesting head-to-head comparison of the interleukin-17 inhibitor ixekizumab (Taltz, Lilly) and the TNF inhibitor adalimumab (Humira, AbbVie). Twenty-four-week efficacy and safety results from the multicenter, randomized, open-label, assessor-blinded study of patients naïve to biologic disease-modifying antirheumatic drugs will be presented.

One big difference between this year and previous EULAR congresses is the integration of pediatric rheumatologists.

"We're trying to better work together on the transition from pediatric to adult rheumatism," Dörner explained. "Pediatric rheumatologists have more insight into certain diseases, and it's the other way around for adult diseases. It's worthwhile to devote a congress to closer interaction."

For example, there will be sessions devoted to autoinflammatory diseases that "are very prevalent in kids." Results from trials of juvenile idiopathic arthritis will also be presented.

Isaacs reports being a consultant for or receiving honoraria and grants from AbbVie, Biogen, Bristol-Myers Squibb, Celltrion, Eli Lilly, Gilead, Janssen, Merck, Pfizer, and Roche. Dörner has disclosed no relevant financial relationships.

European League Against Rheumatism (EULAR) Congress 2019.

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